4 ms·

Taking a horse quantity of any drug is unwise, even one that won the 2015 Nobel Prize (Ivermectin). It still needs large scale RCTs for Covid-19 use, but there

Taking a horse quantity of any drug is unwise, even one that won the 2015 Nobel Prize (Ivermectin). It still needs large scale RCTs for Covid-19 use, but there are some small trials that at least indicate it should be taken seriously and not outright discredited and smeared. "Meta-analysis of randomized trials of ivermectin to treat SARS-CoV-2 infection" - "there was a 56% reduction in mortality; p=0.004 .. with favorable clinical recovery and reduced hospitalization." https://academic.oup.com/ofid/advance-article/doi/10.1093/ofid/ofab358/6316214 https://academic.oup.com/ofid/advance-article/doi/10.1093/of... "Ivermectin was associated with decreased mortality in patients with COVID-19... The certainty of evidence for mortality reduction was low." https://www.sciencedirect.com/science/article/pii/S187140212100206X?via%3Dihub https://www.sciencedirect.com/science/article/pii/S187140212...

WarOnPrivacy 5y ago
We recently learn of strong indicators that the Ivermectin studies were entirely fabricated, much of it was content that was plagiarized from other studies. https://grftr.news/why-was-a-major-study-on-ivermectin-for-covid-19-just-retracted/ https://grftr.news/why-was-a-major-study-on-ivermectin-for-c... If a long life has taught me anything, it's that puzzlingly loud claims of conspiracy are often generated noise to conceal the fact that something simply isn't true.
- swader999 5y ago
  One bad study that didn't even get past preprint? Try the ones here from reputable journals. https://covid19criticalcare.com/ivermectin-in-covid-19/ https://covid19criticalcare.com/ivermectin-in-covid-19/
Mountain_Skies 5y ago
Of course. Veterinary pharmaceuticals have very different manufacturing standards, approvals, and dosages. It's unfortunate that so many have been pushed into this path by authoritarians who have in under a year turned the medical establishment's credibility into a pile of dust.
WarOnPrivacy 5y ago
I see a choice of going down the Invermectin rabbit-hole where the framing and presentation feels a lot like an MLM campaign (except saturated w/ conspiracy) - or walking into a local store and getting sound ~95% efficacy w/ a pair of free Moderna shots. The latter really seems more compelling to me.
- seriousquestion 5y ago
  These shots are not FDA approved yet. Usually that's compelling enough to look for and consider alternatives. Especially existing cheap off patent drugs that have been used billions of times over the course of decades and recently won the Nobel Prize. If that plus many doctors and small trials indicate promise with Covid-19, we should take that seriously. That's all. "The Moderna COVID-19 Vaccine is a vaccine and may prevent you from getting COVID-19. There is no U.S. Food and Drug Administration (FDA) approved vaccine to prevent COVID-19." https://www.fda.gov/media/144638/download https://www.fda.gov/media/144638/download None of this is to say that the vaccines aren't safe or shouldn't be used. They should be, especially for those at risk. The vaccines may well be better than Ivermectin and so far it appears that way. But there is some nuance here and it's valid if people want an alternative until the shots are FDA approved and have long term data. Many are not engaging in critical thinking when it comes to this issue and suddenly have complete trust of big pharma. Which I find bizarre.
  - khuey 5y ago
    When the FDA finally grants full approval to the vaccines the goalposts will just move again to something else.
  - exmadscientist 5y ago
    > Many are not engaging in critical thinking when it comes to this issue and suddenly have complete trust of big pharma. I wasn't first in line to get any of these vaccines. Distrust of anything new is pretty rational! But hundreds of millions of doses delivered, with a complication rate significantly less than the disease itself... that's pretty powerful evidence, no? Especially compared against drugs that have yet to convincingly beat placebos in any large trial? Personally, I find it bizarre that anyone can weight those two sets of evidence so differently.
jollybean 5y ago
Folks you need to realize the difference between 'material discussion' within the scientific community etc. and 'drug populism' i.e. people making stuff up on Twitter and that information flowing to millions. Nobody is 'smearing' the drug or even the people talking abot it. They're saying 'stop telling the public about it because it's not approved yet and potentially dangerous'. Whatever Donald Trump says - people believe. And they will go out in droves, self diagnose, self medicate, demand doctors prescribe them the 'cure' (when the doctor knows they shouldn't) etc.. And the amount of stupid conspiratorial memes that come up are pretty shocking. I avoid FB fro this reason and TikTok had a bunch of that for a bit, but I think they've shut down Ivermectin talk. I quite like Joe Rogan, but he's not a doctor, and neither is his partner in goofydom Brett Weinstein, they have zero medical credibility on the issue, they should straight up not be talking about the drug. If there is some kind of coverup, or there's hard evidence and the FDA is refusing to look at it, or if someone in Big Pharma bribed someone else ... then that's a story, but this is not that. Oxford has just launched a trial for Ivermectin, and there are others. When the results come in, and if it works and is safe, then CNN et. al. will talk about it and parameterize it appropriately. We'll all hear about it pretty quickly. The CDC can't stop Joe Rogan from talking about it and the haven't tried, but they can say 'STFU' until we have done the actual science, which is reasonable.
- pumpkinandspice 5y ago
  > I quite like Joe Rogan, but he's not a doctor, and neither is his partner in goofydom Brett Weinstein, they have zero medical credibility on the issue, they should straight up not be talking about the drug. By this logic, this applies to every single person that aren’t doctors who shouldn’t be talking about the vaccine or the drugs. This includes data scientists and politicians. I’ve watched Dr. Pierre Kory’s full interview with Brett and seems clips of his testimony in front of the senate. He is extremely credible and should have a voice in this as a COVID-19 critical care doctor and who has done meta analysis of the drug (https://covid19criticalcare.com/wp-content/uploads/2020/11/FLCCC-Ivermectin-in-the-prophylaxis-and-treatment-of-COVID-19.pdf https://covid19criticalcare.com/wp-content/uploads/2020/11/F...). I think people like Joe and Brett help amplify voices of people like Dr. Pierre Kory similar to politicians who amplifies Dr. Fauci
raphlinus 5y ago
It's not holding up so well in RCT's, like this one[1] that was just discussed on TWiV 778[2]. BTW, I've joined the legions who are addicted to TWiV. It's a time commitment for sure, but it's fascinating how different the perspective is on important topics (like delta variant) than the mainstream press. [1]: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06348-5 https://bmcinfectdis.biomedcentral.com/articles/10.1186/s128... [2]: https://www.microbe.tv/twiv/twiv-778/ https://www.microbe.tv/twiv/twiv-778/
- mcguire 5y ago
  [1]: "The mean age was 42 years (SD ± 15.5) and the median time since symptom onset to the inclusion was 4 days [interquartile range 3–6]. The primary outcome of hospitalization was met in 14/250 (5.6%) individuals in ivermectin group and 21/251 (8.4%) in placebo group (odds ratio 0.65; 95% confidence interval, 0.32–1.31; p = 0.227). Time to hospitalization was not statistically different between groups. The mean time from study enrollment to invasive mechanical ventilatory support (MVS) was 5.25 days (SD ± 1.71) in ivermectin group and 10 days (SD ± 2) in placebo group, (p = 0.019). There were no statistically significant differences in the other secondary outcomes including polymerase chain reaction test negativity and safety outcomes."
  - forcry 5y ago
    Only a very low dose of Ivermectin was used. From the study limitations.. > Low percentage of hospitalization events, dose of ivermectin and not including only high-risk population. I think one would at least use any of the protocols that were being used by the doctors who are seeing an efficacy.
pjc50 5y ago
The 2015 prize was for its use against worms: https://www.isglobal.org/en/healthisglobal/-/custom-blog-portlet/ivermectina-un-medicamento-de-nobel-pero-poco-accesible/91127/0# https://www.isglobal.org/en/healthisglobal/-/custom-blog-por... It's not clear how that relates to respiratory medicine.

WarOnPrivacy 5y ago

We recently learn of strong indicators that the Ivermectin studies were entirely fabricated, much of it was content that was plagiarized from other studies. https://grftr.news/why-was-a-major-study-on-ivermectin-for-covid-19-just-retracted/ https://grftr.news/why-was-a-major-study-on-ivermectin-for-c... If a long life has taught me anything, it's that puzzlingly loud claims of conspiracy are often generated noise to conceal the fact that something simply isn't true.

swader999 5y ago
One bad study that didn't even get past preprint? Try the ones here from reputable journals. https://covid19criticalcare.com/ivermectin-in-covid-19/ https://covid19criticalcare.com/ivermectin-in-covid-19/

Mountain_Skies 5y ago

Of course. Veterinary pharmaceuticals have very different manufacturing standards, approvals, and dosages. It's unfortunate that so many have been pushed into this path by authoritarians who have in under a year turned the medical establishment's credibility into a pile of dust.

WarOnPrivacy 5y ago

I see a choice of going down the Invermectin rabbit-hole where the framing and presentation feels a lot like an MLM campaign (except saturated w/ conspiracy) - or walking into a local store and getting sound ~95% efficacy w/ a pair of free Moderna shots. The latter really seems more compelling to me.

seriousquestion 5y ago
These shots are not FDA approved yet. Usually that's compelling enough to look for and consider alternatives. Especially existing cheap off patent drugs that have been used billions of times over the course of decades and recently won the Nobel Prize. If that plus many doctors and small trials indicate promise with Covid-19, we should take that seriously. That's all. "The Moderna COVID-19 Vaccine is a vaccine and may prevent you from getting COVID-19. There is no U.S. Food and Drug Administration (FDA) approved vaccine to prevent COVID-19." https://www.fda.gov/media/144638/download https://www.fda.gov/media/144638/download None of this is to say that the vaccines aren't safe or shouldn't be used. They should be, especially for those at risk. The vaccines may well be better than Ivermectin and so far it appears that way. But there is some nuance here and it's valid if people want an alternative until the shots are FDA approved and have long term data. Many are not engaging in critical thinking when it comes to this issue and suddenly have complete trust of big pharma. Which I find bizarre.
- khuey 5y ago
  When the FDA finally grants full approval to the vaccines the goalposts will just move again to something else.
- exmadscientist 5y ago
  > Many are not engaging in critical thinking when it comes to this issue and suddenly have complete trust of big pharma. I wasn't first in line to get any of these vaccines. Distrust of anything new is pretty rational! But hundreds of millions of doses delivered, with a complication rate significantly less than the disease itself... that's pretty powerful evidence, no? Especially compared against drugs that have yet to convincingly beat placebos in any large trial? Personally, I find it bizarre that anyone can weight those two sets of evidence so differently.

jollybean 5y ago

Folks you need to realize the difference between 'material discussion' within the scientific community etc. and 'drug populism' i.e. people making stuff up on Twitter and that information flowing to millions. Nobody is 'smearing' the drug or even the people talking abot it. They're saying 'stop telling the public about it because it's not approved yet and potentially dangerous'. Whatever Donald Trump says - people believe. And they will go out in droves, self diagnose, self medicate, demand doctors prescribe them the 'cure' (when the doctor knows they shouldn't) etc.. And the amount of stupid conspiratorial memes that come up are pretty shocking. I avoid FB fro this reason and TikTok had a bunch of that for a bit, but I think they've shut down Ivermectin talk. I quite like Joe Rogan, but he's not a doctor, and neither is his partner in goofydom Brett Weinstein, they have zero medical credibility on the issue, they should straight up not be talking about the drug. If there is some kind of coverup, or there's hard evidence and the FDA is refusing to look at it, or if someone in Big Pharma bribed someone else ... then that's a story, but this is not that. Oxford has just launched a trial for Ivermectin, and there are others. When the results come in, and if it works and is safe, then CNN et. al. will talk about it and parameterize it appropriately. We'll all hear about it pretty quickly. The CDC can't stop Joe Rogan from talking about it and the haven't tried, but they can say 'STFU' until we have done the actual science, which is reasonable.

pumpkinandspice 5y ago
> I quite like Joe Rogan, but he's not a doctor, and neither is his partner in goofydom Brett Weinstein, they have zero medical credibility on the issue, they should straight up not be talking about the drug. By this logic, this applies to every single person that aren’t doctors who shouldn’t be talking about the vaccine or the drugs. This includes data scientists and politicians. I’ve watched Dr. Pierre Kory’s full interview with Brett and seems clips of his testimony in front of the senate. He is extremely credible and should have a voice in this as a COVID-19 critical care doctor and who has done meta analysis of the drug (https://covid19criticalcare.com/wp-content/uploads/2020/11/FLCCC-Ivermectin-in-the-prophylaxis-and-treatment-of-COVID-19.pdf https://covid19criticalcare.com/wp-content/uploads/2020/11/F...). I think people like Joe and Brett help amplify voices of people like Dr. Pierre Kory similar to politicians who amplifies Dr. Fauci

raphlinus 5y ago

It's not holding up so well in RCT's, like this one[1] that was just discussed on TWiV 778[2]. BTW, I've joined the legions who are addicted to TWiV. It's a time commitment for sure, but it's fascinating how different the perspective is on important topics (like delta variant) than the mainstream press. [1]: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06348-5 https://bmcinfectdis.biomedcentral.com/articles/10.1186/s128... [2]: https://www.microbe.tv/twiv/twiv-778/ https://www.microbe.tv/twiv/twiv-778/

mcguire 5y ago
[1]: "The mean age was 42 years (SD ± 15.5) and the median time since symptom onset to the inclusion was 4 days [interquartile range 3–6]. The primary outcome of hospitalization was met in 14/250 (5.6%) individuals in ivermectin group and 21/251 (8.4%) in placebo group (odds ratio 0.65; 95% confidence interval, 0.32–1.31; p = 0.227). Time to hospitalization was not statistically different between groups. The mean time from study enrollment to invasive mechanical ventilatory support (MVS) was 5.25 days (SD ± 1.71) in ivermectin group and 10 days (SD ± 2) in placebo group, (p = 0.019). There were no statistically significant differences in the other secondary outcomes including polymerase chain reaction test negativity and safety outcomes."
- forcry 5y ago
  Only a very low dose of Ivermectin was used. From the study limitations.. > Low percentage of hospitalization events, dose of ivermectin and not including only high-risk population. I think one would at least use any of the protocols that were being used by the doctors who are seeing an efficacy.

pjc50 5y ago

The 2015 prize was for its use against worms: https://www.isglobal.org/en/healthisglobal/-/custom-blog-portlet/ivermectina-un-medicamento-de-nobel-pero-poco-accesible/91127/0# https://www.isglobal.org/en/healthisglobal/-/custom-blog-por... It's not clear how that relates to respiratory medicine.